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The HPV Vaccine. Protecting Your Adult Child From Their Own Adult Decisions?

Posted by MDViews on January 9, 2013

A medical news article entitled, “Increasing HPV Vaccination Coverage Needed To Decrease HPV-Associated Cancer Incidence,” caught my eye and took me back to my days at Fairview when I was on the Quality committee. The HPV (human papilloma virus) vaccine (Gardasil) had just been release. The chairman of the committee, Mike Dummer, MD, told everyone that we needed to get as many adolescent girls vaccinated as possible. In order to do that, he said, we should present the vaccine to the mothers of these youngsters as a vaccine to prevent cancer of the cervix. We were not to use the word “STD” or sexually transmitted disease when speaking of the vaccine. He feared mothers of adolescent girls would refuse to have their daughters vaccinated if we called it an STD vaccine.

I challenged him and told him I thought that approach was wrong and could violate Fairview’s diversity and tolerance policies by not being culturally sensitive to devoutly religious folks, Christians in particular. I knew some Christian women who did not want their daughters vaccinated against an STD. He shot back that I was wrong, that it was important to tell them it was a cancer vaccine. After all, we didn’t tell patients with cervix cancer or an abnormal pap smear that it was caused by an STD. I challenged him again and told him I always told my patients with an abnormal pap or cancer of the cervix that the disease was from an STD, more likely in those with early onset sexual activity and multiple life time partners. He was truly surprised, that I would honestly share that information with my patients. The conversation ended with him sticking to his guns, that we should not tell moms of young girls that the vaccine was intended to prevent an STD which caused 70% of cervix cancers.

There were probably 15 docs at that meeting. None supported me. I resigned from the committee after that. I could see I didn’t belong there.

I’ve spoken with doctors and patients who fall on both sides of the issue, but most advance the notion that young girls (and now young boys) should receive the vaccine.

Protecting children from physical harm is a parental duty and cervix cancer causes real physical harm. So, aren’t we obligated to protect our young girls from this STD and get them the vaccine? No, I don’t think so. We can give them the vaccine, of course, as many do. But we are not obligated to do so as I argue below.

A child does not catch an STD by a sneeze or a cough so I can’t place this vaccine in the same category as the vaccine for whooping-cough or measles. If I had a preadolescent or adolescent daughter at home today, I would speak to her around the time of her menarche of the availability of the vaccine, its purpose, its effectiveness and encourage her to remain chaste until marriage. Should she decide to become sexually active prior to that, she would be making an adult decision and it would be her job to make another adult decision and go to her own doctor for the vaccine if she wished to receive it or talk to me about her desire to receive the vaccine. And once she were 18, she could make up her own mind without my input.

Cervix cancer is an adult disease. Currently, the CDC doesn’t even recommend a pap test for any woman until age 21. Receiving the vaccine before exposure to the HPV virus 9,11,16 or 18 will theoretically stop 70% of cervix cancers since 70% are caused by 16 and 18. (9 and 11 cause warts.)  Fortunately, even without the vaccine, cancer of the cervix is uncommon and is treatable in its pre-cancer state. 50% of cases of cervix cancer occur in women who have never (that’s right, never) had a pap test.

And, I would contend that sexual intercourse is an adult act.

I have difficulty generating excitement about protecting my adult children from an adult act for which they are responsible.

The other side of the argument cites the irresponsibility and rebelliousness of adolescent boys and girls who may have sex. Is that really an adult act? Shouldn’t you protect her then? What if your daughter gets raped at age 14? Wouldn’t you want her protected in that event? And what about those cultures in our society in which sex at age 15 or 16 is accepted as the norm, multiple partners are the norm and marriage is rare? I’m thinking of inner city minority populations where 80% of babies are born to unmarried women. Shouldn’t they receive the vaccine at age 10 or 11? Shouldn’t you push hard to get them vaccinated, even if it involved lying to them as in, “This is a cancer vaccine, not STD vaccine?”

My own approach on this issue is to inform patients of the vaccines availability but encourage no sex until marriage and one partner for life. That’s a medical recommendation. (What? A medical recommendation?) By remaining chaste until marriage and having one partner for life, an entire plethora of disease can be avoided, including HPV, HIV, Chlamydia, gonorrhea, genital herpes, pelvic inflammatory disease, infertility, hysterectomy and on and on. That’s what I mean by encouraging no sex until marriage, then one partner for life being a medical recommendation.

Think of this. No doctor hesitates to scold a patient for smoking cigarettes and tell them to quit smoking because of the increased risk of lung cancer, heart disease and emphysema. No doctor hesitates to scold the overweight patient and tell them to start exercising and losing weight because of the increased risk of high blood pressure, diabetes and heart disease. No doctor hesitates to tell a patient to wear their seat belt, lower their cholesterol, treat their high blood pressure, get their eyes checked, and on and on and on.

Why the taboo against recommending abstinence until marriage and one partner for life to avoid the diseases which result from promiscuous sexual activity? Mainstream medicine conveys the message that adolescents will have sex like rabbits anyway, so limit disease and pregnancy. Get the vaccine, wear a condom, use birth control, have an abortion if the birth control doesn’t work, don’t ruin you life with a (gasp!) baby.

Only, that message hasn’t worked, doesn’t work and won’t ever work. Just look around. God knew what He was doing when He defined marriage as the union of one man and one woman and that sex outside of the marriage bond was sin. He defined this morality which, no surprise to me, is medically spot on.

5 Responses to “The HPV Vaccine. Protecting Your Adult Child From Their Own Adult Decisions?”

  1. Maddie said

    So there was this girl (in my dorm) who was a freshmen, and I was a junior. She was very Godly. She ran Bible studies, and things like that. She also volunteered a lot. She wasn’t your average hypocrite. Anyways, there was a guy who lived next to my then boyfriend (now husband). He was a rich drug addict (swat raided his room one, that was weird). Well, one night in his drunken stupor, he broke into the girl’s room while she was sleeping. Laid beside her, I’m not sure if, a sexual assault happen (those were common on our campus along with just being creepy).

    So because sometimes people can get STD’s through no fault of their own, even when they don’t party, or drink or flirt, I am making sure my kids (boys and girls included) get the HPV vaccine.

    I have a few stories about guys being assaulted or almost assaulted at University as well, I can’t believe you don’t factor in sexual assault into your worldview. It doesn’t matter how holy you are sometimes bad things will happen (Job anyone).

  2. Erica said

    Unfortunately, this mindset in the culture doesn’t really surprise me. It’s just another symptom of a sick, godless culture. I particularly like your point about counseling patients about weight, smoking, etc., but woe unto the medical professional who dares to encourage no intimacy outside of marriage. So, so, so sad. And to think that the consequences for that are even greater than only medical ones.

    Thankfully, vaccines are, for now, given under permission. And the more friends we talk to about not just the vaccines but the mindset behind them (as you have done effectively), the greater the education can be to help others. Patients can end up feeling like we need to take the advice of doctors, even if they disagree in principle. We’ve delayed and avoided some other “routine” vaccines for our children, and though our doctor doesn’t push us, he does try to encourage us to get them and asks why we don’t/won’t. When they told me our 12 year old SON should be given the HPV vaccine, it was an easy decision. But many, many parents easily fall under the pressure of the “professionals” without really thinking more thoroughly.

    The point about lying to patients…telling them it’s a cancer vaccine, not an STD vaccine…well, that is sure an excellent point! It is sad that the truth is not made manifest, even sometimes by those in “authority.” Thanks for not being one of those doctors!

  3. Maia Hinderman said

    For the wrath of God is revealed from heaven against all ungodliness and unrighteousness of men, who by their unrighteousness suppress the truth. For what can be known about God is plain to them, because God has shown it to them. For his invisible attributes, namely, his eternal power and divine nature, have been clearly perceived, ever since the creation of the world, in the things that have been made. So they are without excuse. For although they knew God, they did not honor him as God or give thanks to him, but they became futile in their thinking, and their foolish hearts were darkened. Claiming to be wise, they became fools, and exchanged the glory of the immortal God for images resembling mortal man and birds and animals and creeping things.
    Therefore God gave them up in the lusts of their hearts to impurity, to the dishonoring of their bodies among themselves, because they exchanged the truth about God for a lie and worshiped and served the creature rather than the Creator, who is blessed forever! Amen.
    For this reason God gave them up to dishonorable passions. For their women exchanged natural relations for those that are contrary to nature; and the men likewise gave up natural relations with women and were consumed with passion for one another, men committing shameless acts with men and receiving in themselves the due penalty for their error.
    And since they did not see fit to acknowledge God, God gave them up to a debased mind to do what ought not to be done. They were filled with all manner of unrighteousness, evil, covetousness, malice. They are full of envy, murder, strife, deceit, maliciousness. They are gossips, slanderers, haters of God, insolent, haughty, boastful, inventors of evil, disobedient to parents, foolish, faithless, heartless, ruthless. Though they know God’s righteous decree that those who practice such things deserve to die, they not only do them but give approval to those who practice them.

    (Romans 1:18-32 ESV)

    Tom and I have been faced with the decision of the HPV vaccine several times now and we have come back to the reality that, as horrible a disease as HPV is, we do not feel comfortable vaccinating against an effect of a lifestyle lived in opposition to God. And truly, I think it gives a false hope that we can sin and there will be no consequences. As parents who believe that we need to be obedient to God in bringing up our children in obedience and the fear of the LORD I think the very real threat of the consequences for sin is necessary. I also know that God will not be mocked and the consequences for sin can not be side stepped by mans making. The only solution is a payment (graciously paid for those who will accept God’s atonement through His Son) and a regeneration and sanctification through the work of the Holy Spirit. So sad to see the worlds foolish attempts to circumvent God’s laws which are so clearly written in nature.
    The fool says in his heart, “There is no God.”
    They are corrupt, they do abominable deeds,
    there is none who does good.
    (Psalm 14:1 ESV)

  4. MDViews said

    Thanks for your comment, Terese.

    This issues clearly demonstrates in my mind that medicine has been hijacked by those whose goal is not healthier women but rather by those who seek a a way to violate God’s laws regarding marriage and family with fewer serious consequences. And I say “God’s laws” on purpose, because it is a war between world views, the one which says we are the pinnacle of God’s creation and beholding to Him for our next breath and the other which says we are all we have, God doesn’t exist, we make our own rules and we are guided by our conscience. (Unbeknownst to them, they are guided by something much more sinister!)

    When will they develop a vaccine to salve the pain and sorrow of serial hooking up? Or of contracting herpes or Chlamydia or gonorrhea? Or those who will still get the abnormal pap smear even after the vaccine? I’ve seen the reaction again and again of women who find out for the first time they have an STD or their pap is abnormal from HPV. There is no vaccine for those tears.

    Matt A.

  5. Terese Shearer, MD said

    This is so true. We can’t talk about sexuality as we talk about other things. The consequences are so much more serious to even one sexual encounter! Compare that to smoking a cigarette, not wearing your seat belt or even taking an ilicit drug one time.

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